ethnobotanical study of plants used in the treatment of ...cals (sharma and mujumdar, 2003). herbal...

© 2020 Journal of Pharmacy & Pharmacognosy Research, 8 (5), 392-409, 2020 ISSN 0719-4250

http://jppres.com/jppres

Original Article | Artículo Original

_____________________________________

Ethnobotanical study of plants used in the treatment of respiratory diseases in a population bordering the forest of Izarène

[Estudio etnobotánico de plantas utilizadas en el tratamiento de enfermedades respiratorias en una población que linda con el bosque de Izarène]

Hicham Orch1*, Lahcen Zidane1, Allal Douira2

1Laboratory of Nutrition, Health and Environment, Department of Biology, UFR: Mycology, Faculty of Sciences, Ibn Tofail University, Kénitra, Morocco. 2Laboratory of Botany and Plant Protection, Department of Biology, Faculty of Sciences, Ibn Tofail University, Kénitra, Morocco.

*E-mail: [email protected]

Abstract Resumen

Context: Ethnobotanical surveys among users of medicinal plants have allowed us to inventory the medicinal species used and to safeguard the maximum of information acquired by the local population in traditional phytotherapy.

Aims: To contribute to a better knowledge of the medicinal plants used in the treatment of respiratory diseases, an ethnobotanical study was carried out among the population bordering the Izarène forest.

Methods: Using 480 questionnaire sheets, ethnobotanical field surveys were conducted during two campaigns (2013 to 2015). The determination of the different survey media was carried out using stratified probability sampling techniques. The ethnobotanical data were analyzed through the calculation of quantitative indices, such as Relative Frequency of Citation (RFC), Family Importance Value index (FIV), Fidelity Level (FL), Informant Consensus Factor (ICF) and Use-Value of the Plant Part (PPV).

Results: Analysis of the results revealed 40 plant species, which fall into 19 botanical families. The Lamiaceae family was the most represented (14 species, FIV = 0.076). The highest Relative Citation Frequency (RFC) (0.22) was recorded for Mentha pulegium. Concerning the diseases treated, asthma had the highest ICF (0.95). The leaf was considered the most used part of the plant (PPV = 0.34), and most of the remedies were prepared as decoctions.

Conclusions: The results obtained could constitute a basis for further studies for the valorization of medicinal plants used against respiratory diseases through biological and phytochemical studies of the inventoried plants.

Contexto: Las encuestas etnobotánicas entre los usuarios de plantas medicinales nos han permitido hacer un inventario de las especies medicinales utilizadas y salvaguardar el máximo de información adquirida por la población local en la fitoterapia tradicional.

Objetivos: Contribuir a un mejor conocimiento de las plantas medicinales utilizadas en el tratamiento de enfermedades respiratorias, se realizó un estudio etnobotánico entre la población que limita con el bosque de Izarène.

Métodos: Utilizando 480 hojas de cuestionarios, se realizaron encuestas de campo etnobotánicas durante dos campañas (2013 a 2015). La determinación de los diferentes medios de encuesta se realizó utilizando técnicas de muestreo de probabilidad estratificadas. Los datos etnobotánicos se analizaron mediante el cálculo de índices cuantitativos, como la frecuencia relativa de citas (RFC), el índice del valor de importancia familiar (FIV), el nivel de fidelidad (FL), el factor de consenso informante (ICF) y el valor de uso de la parte de la planta (PPV).

Resultados: El análisis de los resultados reveló 40 especies de plantas, que se dividieron en 19 familias botánicas. La familia Lamiaceae fue la más representada (14 especies, FIV = 0,076). La frecuencia de cita relativa más alta (RFC) (0,22) se registró para Mentha pulegium. Con respecto a las enfermedades tratadas, el asma tuvo la ICF más alta (0,95). La hoja se consideró la parte más utilizada de la planta (PPV = 0,34), y la mayoría de los remedios se prepararon como decocciones.

Conclusiones: Los resultados obtenidos podrían constituir una base para futuros estudios para la valorización de plantas medicinales utilizadas contra enfermedades respiratorias a través de estudios biológicos y fitoquímicos de las plantas inventariadas.

Keywords: ethnobotanical surveys; Izarène forest; medicinal plants; respiratory diseases.

Palabras Clave: bosque de Izarène; enfermedades respiratorias; estudios etnobotánicos; plantas medicinales.

ARTICLE INFO Received: March 1, 2020. Received in revised form: April 6, 2020. Accepted: April 14, 2020. Available Online: April 19, 2020. Declaration of interests: The authors declare no conflict of interest. Funding: This research was not funded and did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


http://creativecommons.org/licenses/by-nc-nd/3.0/

mailto:[email protected]

Orch et al. Medicinal plants and respiratory diseases in Izarène, Morocco

http://jppres.com/jppres J Pharm Pharmacogn Res (2020) 8(5): 393

INTRODUCTION

Respiratory diseases are heterogeneous disor-ders that affect the airways and other lung struc-tures (WHO, 2007). They commonly include chronic bronchitis, emphysema, asthma, chronic obstructive pulmonary disease, and unclassified chronic airway obstruction (Wang et al., 2007). Respiratory diseases are a very frequent reason for consultation in Morocco, both in the public and private sectors. They represent about 5.5 million medical consultations per year. In the majority of cases (85%), they are acute respiratory infections, mainly angina, and acute bronchitis. The remain-ing cases (15%) are chronic respiratory diseases or suspected pulmonary tuberculosis (Ministère de la Santé, 2001).

In response to the spread of these highly treata-ble diseases, WHO has promoted ethnobotanical studies and pharmaceutical research to improve herbal medicines to promote their optimal use in health care delivery systems (Trabi et al., 2008).

In Morocco, as everywhere in the world, the medicinal plants still find their therapeutic indica-tions in the treatment of several diseases, includ-ing diseases of the respiratory system despite the increasing influence of the modern health system.

Morocco occupies a privileged place among the Mediterranean countries, which have a long medi-cal tradition and traditional know-how based on medicinal plants (Scherrer et al., 2005). The rich-ness of its traditional medicine has been demon-strated by all the studies carried out in the field, which is a heritage of the Arab-Berber civilization and benefited in large part from the Muslim and Jewish tradition, which reigned in this country (Jouad et al., 2003). Indeed, some of these plants have been described in the older Moroccan phar-macopeia (Bellakhdar, 1978; Boulos, 1983), and in several recent but partial and fragmentary ethno-botanical studies (Sijelmassi, 1993; Hmamouchi, 1999).

In the field of pharmacology, traditional herbal knowledge has become a recognized tool in the search for new sources of drugs and pharmaceuti-

cals (Sharma and Mujumdar, 2003). Herbal medi-cines are considered less toxic and milder than pharmaceutical drugs (Dibong et al., 2011).

From this perspective, we have led an ethnobo-tanical study, whose principal objective is to iden-tify and to count the medicinal plants used in the treatment of the respiratory system by the border-ing population of the Izarène forest, which pre-sents a floristic and ecological diversity and offers to the local population a knowledge rather rich in traditional phytotherapy.

MATERIAL AND METHODS

Description of the study area

According to the territorial division of 2015, the forest massif of Izarène is part of the Tangier-Tetouan-Al Hoceïma area. It is located in the North-Western part of the Kingdom 12 km North-East of the town of Ouezzane and covers an ap-proximate forest surface of 14600 ha between the parallels 34°45' and 34°58'N and the meridian lines 5°25' and 5°32'W. Limited to the southern part by marls of the pre-Rifaine Cretaceous nappe, this forest massif is characterized by a rugged relief where altitudes vary approximately between 350 and 680 m (HCEFLCD, 2005).

The study area, the Circle of Mokrisset, is a part of the province of Ouezzane and includes 3 Caïdats (Zoumi, Mokrisset and Brikcha), and 3 rural communes (Zoumi, Ain Baïda and Brikcha) (Fig. 1); it contains a population estimated at 25 000 inhabitants (SPEF, 2004). The geological for-mation of the forest massif is characterized by a tormented relief due to the presence of several hills forming the beginning of the Rifaine Moun-tains on the southern side. These hills are charac-terized by a deep clayey-schist or clayey-marly soil that can reach in some places more than 3 meters of depth. The climate of the area is subhumid with temperate winters, with an average annual rainfall of about 1000 mm. This rainfall is spread over about 70 days throughout the year (November to April). One winter soft practically without cold and very rainy succeeds a dry season and hot of




duration from 3 to 4 months (Askarn, 1982). The vegetable cover is characterized by a rich and di-versified forest formation consisting mainly of vegetation, which testifies to a degradation of the climatic formation of the cork oak (Borgniet et al., 2009). Forest fires constitute one of the main fac-tors of degradation and destruction in the region.

The forest of Izarène has a vital economic, eco-logical, and social importance for the bordering population. It assures the needs of the population for the firewood and work and constitutes the principal source of fodder for the cattle (SPEF, 2004). Beyond its paramount functions, it also plays a role in traditional medicine thanks to the use of the medicinal plants that are part of the means of subsistence of the bordering population.

Methodology

Data collection

During a period from 2013 to 2015, ethnobotan-ical surveys were carried out in different localities, villages, and douars, bordering the Izarene forest, in order to collect as much information as possible about the use of medicinal plants used for treating respiratory tract infections.

The determination of the various mediums of inquiries was achieved thanks to the techniques of probabilistic stratified sampling (Godron, 1971; Godron and Daget 1982). In this study, the sample is divided into four homogeneous strata (S1, S2, S3, and S4), of which three correspond to the numbers of the rural communes of the Circle of Mokrisset (Table 1).

Figure 1. Location map of the study area.




Table 1. Distribution of the surveys by strata.

Strata Names of strata Number of investigations

Strata 1 Mokrisset 120

Strata 2 Zoumi 120

Strata 3 Ain Baïda 120

Strata 4 Brikcha 120

Total 480

The survey was conducted among 480 people

living in villages and douars in the study area. Us-ing a stratified random sampling method, samples of 120 people were then formed for each of the 4 strata and put together to form the overall sample (480 people). The field studies required us to deal with two groups: those who knew and used plants for medicinal purposes and those who used plants and plant products for commercial purposes (plant collectors, herbalists, traditional practitioner). The interviews with the informants were conducted in the Arabic dialect of the region. A questionnaire was prepared from the preliminary surveys in the study area and validated by a team from the bo-tanical laboratory of the Faculty of Sciences of Ke-nitra. The questionnaire used consists of two parts: the first part deals with the demographic charac-teristics of the informants, and the second one fo-cuses on the plants used in the treatment of dis-eases (Appendix 1). The time devoted to each in-terview was approximately two hours, and the oral and written consent of the informants was collected for each interview. All persons who shared their traditional knowledge were informed about the principle of the study, its interest, and the procedure used while respecting the anonymi-ty of the information collected.

Taxonomic identification and conservation of plant species

The plants indicated by the informants were systematically photographed, and botanical sam-ples were collected and placed in the herbarium or a plastic bag with a label indicating its vernacular name. The taxonomic validation of the species was carried out in the laboratory using herbaria and completed with the following documents: Les

plantes médicinales du Maroc by Sijelmassi (1993); Flore pratique du Maroc by Fennane et al. (1999) and Catalogues des plantes vasculaires du Nord du Maroc, incluant des clés d'identification, by Valdés et al. (2002), volumes I and II.

Data analysis

The data recorded on the survey sheets were then transcribed into a database and processed by SPSS (System Professional for Social Sciences) ver-sion 21 and the Excel spreadsheet (version 2010). Descriptive statistical methods were used to ana-lyze the socio-demographic data of informants.

To determine the socio-demographic parame-ters influencing the orientation of the riverside population towards traditional medication, an analytical study using logistic regression was con-ducted.

Analysis of ethnobotanical data was carried out using the Relative Frequency of Citation (RFC), the Family Importance Value (FIV), the Plant Part Value (PPV), Fidelity Level (FL), Informant Con-sensus Factor (ICF) and Use-Value of the Plant Part (PPV).

Relative frequency of citation (RFC)

RFC was calculated to appreciate the local im-portance of each species. The RFC was the result of the Citation Frequency (Fc), that is the number of informants who mentioned the use of the species, divided by the total number (N) of respondents [1] (Tardío and Pardo-de- Santayana, 2008), with (0 < RFC < 1).

RFC = Fc/N [1]




Family Importance Value (FIV)

The Family Importance Value (FIV) identified the importance of medicinal plant families. It was calculated using the method [2] proposed by Ca-dena-González et al. (2013).

FIV = FCfamily/Ns [2]

where FCfamily: RFC is the number of inform-ants mentioning the family and Ns: total number of species in each family. Family use-value is a culturally significant index that can be applied to ethnobotany to calculate the biological value of the plant taxon (Gakuubi and Wanzala, 2012).

Fidelity Level (FL)

The Fidelity Index was calculated to identify the species most commonly used in the treatment of a particular disease. It was calculated according to the method [3] proposed by Friedman et al, (1986).

FL= (Fc/ Ft) 100 [3]

where Fc is the frequency of citation of the spe-cies in the treatment of a particular disease and Ft is the total number of citations of the species.

Informant Consensus Factor (ICF)

It was calculated for each category in order to assess the agreement between informants on the use of plants for specific use categories. It is ob-tained using the following formula [4] (Heinrich et al. 1998).

ICF= (Nur - Nt) / (Nur – 1) [4]

Where Nur is the number of use citations for a disease category and Nt is the number of species used by informants in a given use category. The value calculated from this consensus ranges from 0 to 1 and is close to 1 when the plant is used by a large number of the respondents for a particular disease and/or if information is exchanged be-tween informants on the use of the species for a particular disease, and close to 0 (low) when the plant is randomly selected or if there is no ex-

change of information about use among inform-ants (Yaseen et al., 2015).

Plant Part Value (PPV)

The PPV was calculated to assess the im-portance of each part of the plant used by the re-spondents, it was obtained by the following for-mula [5].

PPV = RUplant part/ RU [5]

where RUplant part is the sum of reported uses per part of the plant and RU is the number of re-ported uses of all parts of the plant

RESULTS AND DISCUSSION

Socio-demographic profile of respondents

The ethnobotanical surveys were carried out on a sample of 480 people, and the results obtained show that men and women are concerned with traditional medicine. However, women have slightly more knowledge about medicinal species compared to men, with a frequency of 75% com-pared to 25% for men (Table 2), which corresponds to a sex ratio of 3.

The predominance of women can be justified by the fact that women are always on the lookout for natural remedies based on medicinal plants, to improve their knowledge of these plants and to maintain their health and that of their families since they are closer to the plants either in their children's medication or in their use in cooking. These results confirm the results of other ethnobo-tanical work carried out at the national level (El Hilah et al., 2016; Ben Akka et al., 2019).

The use of medicinal plants concerns all age groups at the scale of the riparian population of the forest massif of Izarène. The results obtained show a predominance of the elderly, so those with an age of over 60 represent 36.5%. The age groups of [50-59], [40-49], [30-39], [18-29] have a percent-age of 16.7%, 17.9%, 15% and 14%, respectively. Indeed, older persons are expected to provide more reliable information on the traditional use of medicinal plants, because they hold much of the




ancestral knowledge that is transmitted orally. The transmission of this knowledge is currently in danger because it is not always ensured (Anyinam, 1995). The relative transmission of traditional prac-tices from one generation to the next may explain the mistrust of some people, particularly young people, who tend not to believe too much in this traditional medicine (Orch et al., 2017).

Concerning the level of education of the re-spondents in the study area, the results obtained show that the majority of users had been illiterate with a percentage of 48.8%. This relatively high percentage is in direct correlation with the level of education of the local population. Nevertheless, those with primary and secondary education had a significant percentage (27% and 17%, respectively), while those with university education had a per-centage of 8%. Other studies have shown that the knowledge of the population on the use of medici-nal plants is held by illiterate people (Lahsissene et al., 2009; Omer et al., 2012).

The majority of the residents surveyed in this region are married, with a percentage of 85% mar-ried versus 15% single.

Concerning the socio-economic level, 45.2% of the people surveyed had a low socio-economic level, 42.5% were unemployed, and 12.3% had a medium level.

According to the logistic regression model, it appears that the variables: gender, age, and least expensive use are predictors influencing the orien-tation of the riverside population towards tradi-tional medication, pointing out that the least ex-pensive use factor represents an influence of 12 times more than the other factors (Table 3). The high cost of modern medical treatments, their side effects, and the unfavorable socio-economic condi-tions of the local population are the essential fac-tors that push the local population to make exten-sive use of herbal medicine. These results confirm the results achieved by El Hassani in Middle Mou-louya (El Hassani et al., 2013).

Table 2. Socio-demographic characteristics of the participants in the study area.

Variable Distribution Number of informants Percentage (%)

Gender Male 120 25.0

Female 360 75.0

Age group [18-29] 67 14.0

[30-39] 72 15.0

[40-49] 86 17.9

[50-59] 96 20.0

≥ 60 159 33.1

Educational level Illiterate 234 48.8

Primary 128 26.7

Secondary 81 16.9

University 37 7.7

Family situation Married 407 84.8

Single 73 15.2

Monthly income No income 204 42.5

Low income 217 45.2

Average income 59 12.3




Table 3. Statistical analyses of the influence of socio-demographic parameters on confidence in plant use.

Variable Odds-ratio IC for 95%

Lower Upper p-value

Gender 0.189 0.08 0.445 0.000

Age groups 0.294 0.208 0.415 0.000

Educational level 1.147 0.893 1.474 0.282

Family situation 1.203 0.340 4. 254 0.774

Monthly income 1.018 0.572 1.709 1.812

Least expensive use 12.403 5.915 26.009 0.000

Floristic analysis

Botanical families most represented in the study area

The study of medicinal plants led to the identi-fication and listing of 40 species belonging to 19 families and divided into 35 genera. These plants

are presented in alphabetical order. For each plant listed, the scientific name, family, local name, the part used, and the method of preparation adopted by the local population are given, as well as the data of FL, FC, RFC and FIV are shown in Table 4.

Table 4. List of medicinal plants used for the treatment of respiratory diseases in the study area.

Family and scientific name Local name Part used Preparation mode Medicinal use FL %

FC RFC FIV

Amaryllidaceae 0.02

Allium cepa L. Lbesla Bulb Raw AT 100 15 0.031

Allium sativum L. Toum Bulb Raw AT 100 4 0.008

Apiaceae 0.002

Ammoides pusilla (Brot.) Breistr. Noukha Leaves Decoction BC 100 1 0.002

Asteraceae (Compositae) 0.006

Dittrichia viscosa (L.) Greuter Terrahlâ Leaves Decoction BC 100 3 0.006

Boraginaceae 0.010

Echium plantagineum L. Lsanthour Flowers Infusion BC, LC 80 5 0.010

Brassicaceae (Cruciferae) 0.053

Brassica oleracea L. Krumb Leaves Infusion TA 100 24 0.05

Lepidiumsativum L. Habbrchad Seeds Decoction CL, CG, BC 77.1 35 0.073

Raphanus sativus L. Lefjel Roots Powder CL, CG, BC 61.1 18 0.037

Burseraceae 0.019

Boswellia carterii Birdw. Salabân Resin Powder CG 100 9 0.019

Capparaceae 0.008

Capparis spinosa L. Al’Kabbar Fruit Powder CL, AT 75 4 0.008

Cistaceae 0.012

Cistus monspeliensis L. Chtâppa Leaves Decoction AT, CG 66.6 6 0.012




Table 4. List of medicinal plants used for the treatment of respiratory diseases in the study area (continued…).


FC RFC FIV

Fabaceae 0.032

Glycyrrhiza glabra L. Arqsûss Roots Decoction CG, TA, AT, BC 68 25 0.052

Trigonella foenum-graecum L. Al’Houlba Seeds Powder BC, AT, CG 66.6 6 0.012

Gentianaceae 0.035

Centaurium Erythraea Rafn Gossat Al’Hayya Aerial parts Decoction, infusion AT 100 17 0.035

Geraniaceae 0.023

Geranium rotundifolium L. Mersetadialouad Leaves Decoction CL 100 11 0.023

Lamiaceae 0.076

Ajuga iva (L.) Schreb. Chendgûra Leaves Other TB 100 1 0.002

Calamintha officinalis Moench Manta Aerial parts Infusion CL, CG 70.8 48 0.1

Lavandula dentata L. Lakhzama Flowers Decoction FL, CL, AT 71.8 64 0.133

Lavandula stoechas L. Al’Halhal Leaves Decoction CL, CG, FL 62 50 0 .104

Marrubium vulgare L. Merriwta Leaves Infusion AT, BC 78.2 55 0.114

Mentha pulegium L. Fliyou Aerial parts Infusion, poultice, and inhalation

CL, CG, AT, TA 52.4 105 0.22

Mentha suaveolens Ehrh. Mchichtrô Leaves Infusion TB 100 8 0.017

Mentha viridis L. Naanaâ Aerial parts Infusion TA 100 25 0.052

Ocimum basilicum L. Lahbak Leaves Decoction, infusion TA 100 5 0.010

Origanum compactum Bentham. Zaâtar Leaves Infusion CL, FL, TA 58.1 62 0.13

Origanum majorana L. Merdedouch Leaves Infusion CG 100 23 0.048

Rosmarinus officinalisL. Aazir Leaves Decoction AT 100 12 0.025

Salvia OfficinalisL. Assalmiya Leaves Decoction CL 100 17 0.035

Thymus ssp (vulgaris) Zaîtra Aerial parts Decoction CL, FL, CG, TA 77.1 35 0.073

Myrtaceae 0.045

Eucalyptus globulus Labill Al’ Kalitûs Leaves Decoction AT, CG, FL 61.9 63 0.131

Eugenia caryophyllata Thunb Qronfel Flowers Decoction, powder, and maceration

LC 100 2 0.004

Myrtus communis L. Arraihan Leaves Decoction, infusion TB 100 1 0.002

Oleaceae 0.135

Olea europaea L. Zitoun, Zabbouj Seeds Other TA, CG 76.9 65 0.135

Poaceae 0.008

Avena sativa L. El khortale Seeds Decoction TA 100 4 0.008

Ranunculaceae 0.125

Nigella sativa L. Assânûj Seeds Decoction, powder FL, BC, AT 65 60 0.125

Rosaceae 0.010

Crataegus oxyacantha L. Admame Leaves, flowers

Decoction AT, CG, BC 60 5 0.010




Table 4. List of medicinal plants used for the treatment of respiratory diseases in the study area (continued…).


FC RFC FIV

Rutaceae 0.067

Citrus limon(L.) Brum. Lhâmmed Fruit Other CL, CG, BC 75 32 0.067

Zingiberaceae 0.067

Alpinia officinarum Han. Khdenjâl Rhizome Powder CL, FL, BC 62.9 27 0.056

Elettaria cardamomum Roxb. Maton.

Kaâ kola Fruit Decoction CL 100 3 0.006

Zingiber officinal Rosc. Sekinjbîr Rhizome Decoction, powder, and maceration

CL, FL, TA, CG 52.2 67 0.14

AT: Asthma, CL: Cold, FL: Flu, TA: Throat affection, CG: Cough, BC: Bronchitis, TB: Tuberculosis, LC: Lung Cancer. FIV=Family importance valueindex; FC= Number of informants; RFC=Relative frequency of citation, FL = Fidelity level.

The number of species and the FIV index re-

vealed three families with high values and which are, therefore, predominant in the treatment of respiratory diseases (Fig. 2). These are Lamiaceae (14 species with FIV = 0.076), Zingiberaceae (3 spe-cies with FIV = 0.067), Brassicaceae (3 species with FIV = 0.053), and Myrtaceae (3 species with FIV = 0.045). The remaining families had only one or two species. This representativeness was also ob-served, with some differences, during ethnomedi-cal surveys carried out in other regions of the country by El Hilah et al. (2015) and Chaachouay et al. (2019).

Figure 2. Distribution of medicinal plants according to the family importance value (FIV) in the study area.

Relative Frequency of Citation (RFC) and Fidelity Level (FL)

Some species were more recommended by the local population than others; this is reflected by a

high citation frequency (FC). The value of the rela-tive frequency of citation (RFC) as numerical rep-resentatives in the quantitative ethnobotanical survey serves to underline the importance of tradi-tional knowledge. Species with a very significant relative citation frequency are those with a high level of use.

Among these plants, seven species belonging to five botanical families were frequently used by the bordering population in the treatment of respirato-ry diseases. These are: Mentha pulegium (RFC=0.22), Zingiber officinal (RFC=0.14), Olea euro-paea (RFC=0.135), Lavandula dentata (RFC=0.133), Eucalyptus globulus (RFC=0.125), Origanum compac-tum (RFC=0.13) and Nigella sativa (RFC=0.125).

Some of these plants have been reported in re-cent ethno-medicinal surveys in the treatment of respiratory diseases (El Hilah et al., 2015; Chaachouay et al., 2019). Among these plants are Mentha pulegium, Zingiber officinal, Eucalyptus glob-ulus, Origanum compactum and Lavandula dentata.

In addition, some of the listed plants are known to be toxic, such as Salvia officinalis (Bruneton, 1996), Mentha pulegium (Franchomme and Penoël, 2001), and Nigella sativa (Zaoui et al., 2000; Ali and Blunden, 2003). Indeed, the majority of phytother-apists are unaware of the toxicity of the plants used as well as the modalities of their use, in par-ticular the modes of preparation and the recom-mended doses. The use of medicinal plants must be rationalized, and the benefit/risk determined. Studies on these objectives are therefore necessary.




The fidelity index value (FL) is an important means of determining, which disease a particular species is more effective, a high FL indicates a high use of plant species for a particular disease, while a low FL demonstrates a wide range of medicinal uses but with a low frequency for each disease (Yaseen et al., 2015).In the present study, the ma-jority of plants had a high FL, and the highest 100% FL was recorded for 37 plant species (Table 4). Only 3 species had low fidelity values (FL < 60). Among the species with the highest fidelity for the treatment of a wide range of respiratory diseases are Mentha pulegium, which has the highest FL for the treatment of colds (FL = 52.4%) and Zingiber officinal, which is used most often for the treatment of throat diseases (FL = 52.2%). Indeed, these re-sults have been confirmed by similar ethnobotani-cal studies carried out in the Central Plateau (El Hilah et al., 2015) and in the Rif region (Chaachouay et al., 2019).

Frequency of Use of the medicinal plants according to their origin

The ethnobotanical study allowed us to identify 40 medicinal plants used in the treatment of dis-eases of the respiratory system. Among them, 16 species were imported from other regions of the country, while 9 species were cultivated, and 15 species had collected from the forest of Izarene. This high use of local species can be explained by the high price of imported medicinal plants by the free and proximity of local medicinal plants. It should be noted that among the spontaneous me-dicinal species collected in the Izarène forest, three medicinal plants: Origanum compactum, Ajuga iva and Centaurium erythraea are scarce in the region (Orch et al., 2013) and risk disappearing from the forest if no protective measures are taken by the services concerned, due to the intensive collection of these species.

Ethnobotanical analysis

Used parts

For the treatment of respiratory diseases, sever-al parts of the listed plants were exploited by the local population (leaves, seeds, flowers, roots). The

calculation of the PPV usage index showed that leaves were the most used parts with an index PPV= 0.34, followed by the aerial part with an in-dex PPV= 0.224, then the seeds (PPV= 0.165). The other parts were used to a lesser degree (Fig. 3). Indeed, these results have been confirmed by simi-lar ethnobotanical studies carried out in other re-gions of Morocco (Sbai-Jouilil et al., 2017; Chaachouay et al., 2019). Leaves are the most widely used because they are at the same time central to photochemical reactions and reservoirs of organic matter derived from them, therefore rich in active principles, and are easy to harvest.

Figure 3. Different parts used for the treatment of respiratory diseases in the zone of study.

Method of preparation and administration used

The population bordering the forest of Izarène uses several methods of preparation for the treat-ment of respiratory ailments (decoction, infusion, powder) to administer the active ingredients con-tained in the medicinal plants. The decoction was the most used mode of administration with a per-centage of 42.9% (Fig. 4), followed by the Infusion preparation with a percentage of 24.5% and the use of the plant powder with a percentage of 16.3%, the other modes of preparation namely maceration, inhalation, cataplasm and others also had represented 16.3%. The high percentage of decoction preparation shows that the local popula-tion believes in this type of preparation and finds it adequate to warm the body and disinfect the plant to cancel the toxic effect of some recipes, but




the decoction can destroy some active ingredients of the species used.

Figure 4. Percentages of different modes of remedies preparation used in the zone of study.

In the area studied, the oral route was the most widely used for most plants. However, most of the respondents were unaware of the weights, the dose, and the precise measurements to be pre-scribed in the preparation and dosage of the phy-tomedicines.

The Informant Consensus Factor (ICF)

The Informant Consensus Factor (ICF) reflects the homogeneity of information provided by dif-ferent informants regarding the medicinal plants used to treat a category of diseases. Table 5 shows that the ICF values range from 0.72 to 0.95 per use category. A total of 40 species were identified to treat respiratory diseases. The categories with the highest ICF values were asthma (0.95), followed by cold (0.94), flu (0.93), throat affection (0.92), and cough (0.91). These high ICF values reflect the rea-sonable reliability of informants on the use of herbal species (Lin et al., 2002) and indicate that natural remedies are considered to be extremely effective. Therefore, species with a high ICF should be prioritized for further pharmacological and phytochemical studies to discover new active molecules.

The lowest agreement among informants was observed for herbal medicines used to treat bron-chitis (0.77), tuberculosis (0.77), and lung cancer (0.72). These values highlight a marked non-homogeneity in the consensus for these categories and may indicate a lack of specific use for a set of species. In agreement with Neves et al. (2009), a low ICF could also be due to the availability of

readily available synthetic drugs that represent a better alternative to traditional drugs.

Origin of information on medicinal plants

Regarding the therapeutic use of medicinal plants, the majority of respondents gathered in-formation through the experience of people around them (62.8%), which reflects the image of the relative transmission of traditional practices from one generation to the next. Herbalists are ranked as the second source of information (20.6%) and a small minority (16.6%) through their own experience via television programs (Fig. 5).

Figure 5. Modes of acquisition of traditional knowledge.

CONCLUSIONS

The ethnobotanical surveys conducted as part of this study have highlighted the medicinal plant potential and the traditional knowledge related to the use of plants among the riparian population of the Izarène forest.

A total of 40 plants of therapeutic value were identified and used in the treatment of respiratory ailments. The qualitative analysis showed a strong association between the orientation of the local population towards traditional medication and specific socio-demographic characteristics. In fact, low cost, gender, and age are the essential factors that push the local population towards this medi-cation. Similarly, the list of species collected con-tains toxic plants. In the light of this study, we would like to make the local population aware of the risks of the anarchic use of plants for therapeu-tic purposes.




This work constitutes an information source that contributes to a knowledge of the medicinal flora and the preservation of the popular local know-how. It can also constitute a database for

phytochemists and pharmacologists for the valori-zation of medicinal plants used in respiratory dis-eases to discover new active ingredients that can be used in pharmacology.

Table 5. Informant Consensus Factor (ICF) values by categories for the treatment of respiratory diseases.

Categories List of plant species used (number of citations) Total number of

ICF Species Use citations

Asthma (AT) Allium cepa L. (15), Allium sativum L. (4), Capparis spinosa L. (1), Cistus monspeliensis L. (2), Glycyrrhiza glabra L. (17), Trigonella foenum-graecum L. (4), Centaurium erythraea Rafn (17), Lavandula dentata L. (46), Marrubium vulgare L. (43), Mentha pulegium L. (44), Rosmarinus officinalis L. (12), Eucalyptus globulus Labill (sp.) (39), Nigella sativa L. (39), Crataegus oxyacantha L. (3).

14 286 0.95

Cold (CL) Lepidium sativum L. (27), Geranium rotundifolium L. (11), Calamintha officinalis Moench (34), Lavandula dentata L. (5), Lavandula stoechas L. (31), Mentha pulegium L. (55), Origanum compactum Bentham. (10), Salvia officinalis L. (17), Thymus ssp (vulgaris) (1), Citrus limon (L.) Brum. (24), Alpinia officinarum Han. (17), Elettaria cardamomum Roxb. Maton. (3), Zingiber officinal Rosc. (5).

13 240 0.94

Flu (FL) Lavandula dentata L. (13), Lavandula stoechas L. (4), Origanum compactum Bentham. (36), Thymus ssp (vulgaris) (27), Eucalyptus globules Labill (sp.) (5), Nigella sativa L. (9), Alpinia officinarum Han. (6), Zingiber officinal Rosc. (15).

8 115 0.93

Throat affection (TA)

Brassica oleracea L. (24), Glycyrrhiza glabra L. (2), Mentha pulegium L. (1), Mentha viridis L. (25), Ocimum basilicum L. (5), Origanum compactum Bentham. (16), Thymus ssp (vulgaris) (1), Olea europaea L. (15), Avena sativa L. (4), Zingiber officinal Rosc. (35).

10 128 0.92

Cough (CG) Lepidium sativum L. (3), Raphanus sativus L. (11), Boswellia carterii Birdw. (9), Cistus monspeliensis L. (4), Glycyrrhiza glabra L. (3), Trigonella foenum-graecum L. (1), Calamintha officinalis Moench (14), Lavandula stoechas L. (15), Mentha pulegium L. (5), Origanum majorana L. (23), Thymus ssp (vulgaris)(6), Eucalyptus globulus Labill (19), Olea europaea L. (50), Crataegus oxyacantha L. (1), Citrus limon (L.) Brum. (5), Zingiber officinal Rosc. (12).

16 181 0.91

Bronchitis (BC) Ammoides pusilla (Brot.) Breistr. (1), Dittrichia viscosa (L.) Greuter (3), Echium plantagineum L. (4 ), Lepidium sativum L. (5), Raphanus sativus L. (1), Glycyrrhiza glabra L. (3), Trigonella foenum-graecum L. (1), Marrubium vulgare L. (12), Nigella sativa L. (12), Crataegus oxyacantha L. (1), Citrus limon(L.) Brum. (3), Alpinia officinarum Han. (4).

12 50 0.77

Tuberculosis (TB)

Ajuga iva (L.) Schreb. (1), Mentha suaveolens Ehrh. (8), Myrtus communis L. (1).

3 10 0.77

Lung cancer (LC)

Echium plantagineum L. (1), Raphanus sativus L. (6), Capparis spinosa L. (3), Eugenia caryophyllata Thunb (2).

4 12 0.72




CONFLICT OF INTEREST

The authors declare no conflict of interest.

ACKNOWLEDGMENTS

The authors would like to thank all the residents of the Izarène region and all the people who contributed to the real-ization of this work. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

REFERENCES

Ali BH, Blunden G (2003) Pharmacological and toxicological properties of Nigella sativa. Phytother Res 17: 299–305.

Anyinam C (1995) Ecology and ethnomedicine. Exploring links between current environmental crisis and indigenous medical practices. Soc Sci Med 40(3): 321-329.

Askarn O (1982) Comportement des Résineux dans l’Arboretum d’Izarène. Mémoire de Troisième Cycle Agronomie, Institut Agronomique et Vétérinaire Hassan II, Rabat, Maroc, 122 pp.

Bellakhdar J (1978) Médecine traditionnelle et toxicologie ouest-sahariennes. Contribution à l’étude de la pharmacopée Marocaine. Rabat, Maroc: Editions techniques Nord-Africaines, pp. 365.

Ben Akka F, Salhi S, Benkhnigue O, Dahmani J, Douira A, Zidane L (2019) Ethnobotanical study of medicinal plants used in the region of middle Oumrbia (Morocco). Plant Arch 19(2): 2005–2017.

Borgniet L, Long M, Capel AC, Bouillon C, Morge D, Ganteaume A, Lampin C, Jappiot M, Curt T, Machrouh A, Sesbou A, Mantzavelas A, Apostolopoulou I, Partozis T, Gitas I, Marell A, Cassagne N, Pimont F, Rigolot E, Morsdorf F, Koetz B and Allgower B (2009) Development of an easy to use tool to recognize and map fuel models. Deliverable D5.1-6 of the Integrated Project “Fire Paradox”, Project no. FP6-018505. European Commission. 112 pp.

Boulos L (1983) Medicinal Plants of North Africa. Algonac: Reference Publications Incorporated.

Bruneton J (1996) Pharmacognosie – Phytochimie Plantes Médicinales. 2ème éd. Lavoisier, 1120 pp.

Cadena-González AL, Sørensen M, Theilade I (2013) Use and valuation of native and introduced medicinal plant species in Campo Hermoso and Zetaquira, Boyacá, Colombia. J Ethnobiol Ethnomed 9: 1–34.

Chaachouay N, Benkhnigue O, Fadli M, El Ayadi R, Zidane L (2019) Ethnopharmacological studies of medicinal and aromatic plants used in the treatment of respiratory system disorders in the Rif, Morocco. Ethnobot Res Appl 18: 22.

Dibong S D, Mpondo ME, Nigoye A, Kwin MF, Betti JL (2011) Ethnobotany and phytomedicine of medicinal plants sold in Douala markets [French]. J Appl Biosci 37: 2496–2507.

El Hassani M, Douiri EM, Bammi J, Zidane L, Badoc A, Douira A (2013) Plantes médicinales de la Moyenne Moulouya (Nord-Est du Maroc). Ethnopharmacologia 50: 39–53.

El Hilah F, Ben Akka F, Dahmani J, Belahbib N, Zidane L (2015) Étude ethnobotanique des plantes médicinales utilisées dans le traitement des infections du système respiratoire dans le plateau central marocain. J Anim Plant Sci 25(2): 3886–3897.

El Hilah F, Ben Akka F, Bengueddour R, Rochdi A, Zidane L (2016) Étude ethnobotanique des plantes médicinales utilisées dans le traitement des affections dermatologiques dans le Plateau Central Marocain. J Appl Biosc 98: 9252–9260.

Fennane M, Ibn Tattou M, Mathez J, Ouyahya A, El Oualidi J (1999) Flore pratique du Maroc, Vol. I. Trav. Inst. Sci. Rabat, série botanique 36. 558 pp. Rabat.

Franchomme P, Penoël D (2001) L’aromathérapie exactement. Paris: Ed. Roger Jollois, 480 pp.

Friedman J, Yaniv Z, Dafni A, Palewitch D (1986) A preliminary classification of the healing potential of medicinal plants, based on a rational analysis of an ethnopharmacological field survey among Bedouins in the Negev Desert, Isr. J Ethnopharmacol 16(2–3): 275–287.

Gakuubi MM, Wanzala W (2012) A survey of plants and plant products traditionally used in livestock health management in Buuri district, Meru County, Kenya. J Ethnobiol Ethnomed 8: 1–19.

Godron M (1971) Essai sur une approche probabiliste de l’écologie des végétations. Thèse Doct. D’Etat, U.S.T.L. Montpellier, pp. 247.

Godron M, Daget Ph (1982) Analyse de l’écologie des espèces dans les communautés. Collection d'écologie 18, Paris: Masson, pp. 163.

HCEFLCD (2005) Haut Commissariat des Eaux et Forêts et de la lutte contre la désertification: Incendie de forêt au Maroc, situation actuelle et persp d’avenir, pp. 10.

Heinrich M, Ankli A, Frei B, Weimann C, Sticher O (1998) Medicinal plants in Mexico: Healers consensus and cultural importance. Soc Sci Med 47(11): 1859–1871.

Hmamouchi M (1999) Les plantes médicinales et aromatiques marocaines. Editions Fedala, Mohammedia, 450 pp.

Jouad H, Maghrani M, El Hassani RA, Eddouks M (2003) Hypoglycemic activity of aqueous extract of Eucalyptus globulus in normal and streptozotocin-induced diabetic rats. J Herbs Spic Med Plants 10: 19–28.

Lahsissene H, Kahouadji A, Tijane M, Hseini S (2009) Catalogue des plantes médicinales utilisées dans la région de Zaër (Maroc occidental). Lejeunia 186: 1–26.




Lin J, Puckree T, Mvelase TP (2002) Anti-diarrhoeal evaluation of some medicinal plants used by Zulu traditional healers. J Ethnopharmacol 79(1): 53–56.

Ministère de la Santé (2001) Guide pratique pour la prise en charge des maladies respiratoires dans les services de sante publiques spécialisés du Maroc, p 58. Direction de l’Epidémiologie et de Lutte Contre les Maladies.

Neves JM, Matos C, Moutinho C, Queiroz G, Gomes LR (2009) Ethnopharmacol notes about ancient uses of medicinal plants in Tras-os-Montes (Northern of Portugal). J Ethnopharmacol 124: 270–283.

Omer SA, Elobeid MA, Elamin MH, Hassan ZK, Virk P, Daghestani MH, Al-Olayan EM, Al-Eisa NA, Almarhoon ZM (2012) Toxicity of olive leaves (Olea europaea L.) in Wistar albino rats. Asian J Anim Vet Adv 7: 1175–1182.

Orch H, Zidane L, Douira A (2013) Contribution à la connaissance de la Flore vasculaire du massif d'Izarène (Nord Ouest Maroc). J Anim Plant Sci 20(2): 3093–3112.

Orch H, Zidane L, Douira A (2017) Ethnobotanical study of the plants used in the treatment of the digestive diseases by the riverine population of the forest of Izarène. Inter J Rec Sci Res 8(1): 15213–15220.

Sbai-Jouilil H, Fadli A, El Hafian M, El Ayad R, Benharbit O, Zidane L (2017) Floristic and ethnobotanical study of medicinal plants used in the treatment of respiratory diseases in Seksaoua region (West H Moroccan Atlas). Ann Res Rev Biol 17(6): 1–10.

Scherrer AM, Motti R, Weckerle CS (2005) Traditional plant use in the areas of Monte Vesole and Ascea, Cilento National Park (Campania, Southern Italy). J Ethnopharmacol 97: 129–143.

Sharma PP, Mujumdar AM (2003) Traditional knowledge on plants from Toranmal plateu of Maharashtra. Indian J

Tradit Know 2: 292–296.

Sijelmassi A (1993) Les plantes médicinales du Maroc, 6ème édit. Casablanca: Fennec. 285 pp.

SPEF (2004) Incendie du massif forestier d’Izarene du 23 au 25 août 2004. Service Provincial des Eaux et Forêts de Chefchaouen, 17 pp.

Tardío J, Pardo-de-Santayana M (2008) Cultural importance indices: a comparative analysis based on the useful wild plants of Southern Cantabria (Northern Spain). Econ Bot 62(1): 24–39.

Trabi FH, Irié GM, N’gaman KCC, Mohou CHB (2008) Études de quelques plantes thérapeutiques utilisées dans le traitement de l’hypertension artérielle et du diabète: deux maladies émergentes en Côte d’Ivoire. Sci Nat 5(1): 39–48.

Valdés B, Rejdali M, Achhal el Kadmiri A, Jury JL (2002) Catalogues des plantes vasculaires du nord du Maroc, incluant des clés d’identification, (2Vol). 1498 pp. Madrid.

Zaoui A, Cherrah Y, Lacaille-Dubois MA, Settaf A, Amarouch H, Hassar M (2000) Diuretic and hypotensive effects of Nigella sativa on the spontaneously hypertensive rat. Therapie 55: 379–382.

Yaseen G, Ahmad M, Sultana S, Alharrasi AS, Hussain J, Zafar M, Ur-Rehman S (2015) Ethnobotany of medicinal plants in the Thar Desert (Sindh) of Pakistan. J Ethnopharmacol 163: 43–59.

Wang YC, Lin JM, Lin CY, Li LT, Guo YL, Sung FC (2007) Prevalence and risks of chronic airway obstruction. Chest 131(3): 705–710.

WHO - World Health Organization (2007) Global Surveillance, Prevention and Control of Chronic Respiratory Diseases A Comprehensive Approach, Geneva, 155 pp.

_________________________________________________________________________________________________________

AUTHOR CONTRIBUTION:

Contribution Orch H Zidane L Douira A

Concepts or ideas x x

Design x x x

Definition of intellectual content x x x

Literature search x x

Experimental studies x x

Data acquisition x x

Data analysis x

Statistical analysis x

Manuscript preparation x x x

Manuscript editing x x

Manuscript review x x x

Citation Format: Orch H, Zidane L, Douira A (2020) Ethnobotanical study of plants used in the treatment of respiratory diseases in a population bordering the forest of Izarène. J Pharm Pharmacogn Res 8(5): 392–409.




Appendix 1. Questionnaire sheets: Medicinal plants and phytotherapy.

Date................................................ Commune.......................................

Caïdat ............................................ Survey number...............................

Age Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

[18-30[

[30-40[

[40-50[

[50-60[

> 60

Job Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Sex Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Male

Female

Family situation Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Single

Married

Level of study Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Illiterate

Primary

Secondary

University

Locality Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Village

Douar

Income / month (MAD) Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

No income

Low income

Average income

When you feel sick, you address:

Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Traditional medicine

Modern medicine

Traditional medicine and Modern medicine

To traditional medicine, why?


Effective

Cheapest

Acquisition




Appendix 1. Questionnaire sheets: Medicinal plants and phytotherapy (continued…).

Plant Type Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Ineffective medication

Spontaneous

Cultivated

Introduced

Use of the plant Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Therapeutic

Cosmetic

Other

Harvesting technique Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Manual

Mechanical

Harvest Time Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Summer

Fall

Winter

Spring

Any year

If desiccated, drying method


Sun exposure

In the shade

Use of the plant Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Fresh

Desiccated

After treatment

Used part Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Fruit

Stem

Whole plant

Seed

Rhizome

Other combination

Root

Bark

Leaf

Flower

Bulb





Form of employment Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Tisane

Powder

Essential oil

Oily oil

Tincture

Method of preparation Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Decoction

Infusion

Cataplasm

Raw

Cooked

Powder

Maceration

Others

Dose used Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Pinch

Handle

Spoonful

Administration mode Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Oral

Massage

Rinse

Brushing

Inhalation

Others

Dosage for children Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

1time/day

2time/day

3time/day

Other

Dosage for adults Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

1time/day

2time/day

3time/day

Other

Dosage for older people Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

1time/day

2time/day

3time/day

Other





Length of Use Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

One day

A week

One month

Until healing

Conservation method Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Sheltered from the light

Exposed to light

Other

Diagnosis By Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Himself

Doctor

Herbalist

Other

Results Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

Healing

Improvement

Ineffective

Side effects Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

No

Yes

Toxicity Mokrisset (S1) Zoumi (S2) Ain Baïda (S3) Brikcha (S4) Total

No

Yes


ethnobotanical study of plants used in the treatment of ...cals (sharma and mujumdar, 2003). herbal...

Documents